Provider Demographics
NPI:1578237517
Name:FIZIOLOGIX PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:FIZIOLOGIX PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:
Authorized Official - Last Name:SPOONER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:206-795-4184
Mailing Address - Street 1:19442 1ST AVE NE
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-7382
Mailing Address - Country:US
Mailing Address - Phone:360-860-3100
Mailing Address - Fax:360-205-3587
Practice Address - Street 1:7865 NE DAY RD W STE 202
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-6212
Practice Address - Country:US
Practice Address - Phone:360-860-3100
Practice Address - Fax:360-205-3587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-03
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty